PROSPERO

International prospective register of systematic reviews

Impact of personal protective equipment on health care workers’ health during the COVID-19
pandemic

Citation

Petros Galanis, Irene Vraka, Despoina Fragkou, Angeliki Bilali, Daphne Kaitelidou. Impact of personal protective
equipment on health care workers’ health during the COVID-19 pandemic. PROSPERO 2021 CRD42021228221
Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021228221

Review question
What is the impact of personal protective equipment use on health care workers’ health during COVID-19 pandemic?
Also, we will investigate factors that affect the impact of personal protective equipment use on health care workers’
health e.g. duration of shifts wearing PPE, grade of PPE etc.

Searches
PubMed, MEDLINE, Scopus, ProQuest, CINAHL, and medRχiv from January 2020 to December 27 2020. We will
search the keywords on title/abstract.

Search strategy on PubMed

(("health care worker*"[Title/Abstract] OR "healthcare worker*"[Title/Abstract] OR "healthcare

personnel"[Title/Abstract] OR "health care personnel"[Title/Abstract] OR "health personnel"[Title/Abstract] OR "health
care professional*"[Title/Abstract] OR "healthcare professional*"[Title/Abstract] OR staff[Title/Abstract] OR "nursing
staff"[Title/Abstract] OR professional*[Title/Abstract] OR worker*[Title/Abstract] OR doctor*[Title/Abstract] OR
physician*[Title/Abstract] OR clinician*[Title/Abstract] OR nurs*[Title/Abstract] OR midwives[Title/Abstract] OR
midwife*[Title/Abstract] OR paramedic*[Title/Abstract] OR practitioner*[Title/Abstract]) AND ("personal protective
equipment"[Title/Abstract])) AND (COVID-19[Title/Abstract] OR COVID19[Title/Abstract] OR
COVID[Title/Abstract] OR SARS-CoV*[Title/Abstract] OR "Severe Acute Respiratory Syndrome
Coronavirus*"[Title/Abstract] OR coronavirus*[Title/Abstract])

Types of study to be included

Observational studies

Condition or domain being studied

The impact of personal protective equipment on health care workers’ health during COVID-19 pandemic could be in
terms of skin reactions, headaches, physical well-being, dermatitis, allergies, pain, dyspnoea, etc.

Participants/population
Health care workers that use personal protective equipment in the management of COVID-19 patients.

Intervention(s), exposure(s)
Inclusion criteria: health care workers that use personal protective equipment in the management of COVID-19 patients,

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health care workers working in healthcare facilities, studies conducted during COVID-19 pandemic.

Comparator(s)/control
Not applicable

Main outcome(s)
Complications of personal protective equipment use among health care workers. These complications could be skin
reactions, headaches, physical well-being, dermatitis, allergies, pain, dyspnoea, etc. We will calculate the prevalence of
adverse events due to PPE
Measures of effect
Probably, odds ratios and beta regression coefficients

Additional outcome(s)
None
Measures of effect
Not applicable

Data extraction (selection and coding) [1 change]

Two independent reviewers will perform study selection and discrepancies will be resolved by a third, senior reviewer.
We will initially screen the title and abstract of the records and then full-text. We will include studies that examine
impact of PPE use on HCWs’ health during COVID-19 pandemic. Also, we will include studies examining factors
related with a greater risk of adverse events among HCWs due to PPE use. We will examine articles that are published in
English, except reviews, qualitative studies, protocols, case reports, editorials, and letters to the Editor. All types of
HCWs directly involving in the management of COVID-19 patients will be accepted for inclusion, while we will exclude
studies with health care students and general population.

We will use structured forms to extract data from each study, such as authors, location, gender, age, sample size, study
design, sampling method, assessment tool, response rate, data collection time, publication (journal or pre-print service),
type of profession, factors associated with complications, and the level of analysis (univariate or multivariable).

Risk of bias (quality) assessment [1 change]

We will assess the quality of studies included using the Joanna Briggs Institute critical appraisal tools.

Two reviewers will use the Joanna Briggs Institute critical appraisal tools to assess quality of studies as poor, moderate or
good. Regarding cross-sectional studies, an 8-point scale is used with a score of ≤3 refers to poor quality, a score of 4-6
points refers to moderate quality, and a score of 7-8 points refers to good quality.

The following criteria (Joanna Briggs Institute critical appraisal tools) will be assessed:

1. Were the criteria for inclusion in the sample clearly defined?

2. Were the study subjects and the setting described in detail?

3. Was the exposure measured in a valid and reliable way?

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4. Were objective, standard criteria used for measurement of the condition?

5. Were confounding factors identified?

6. Were strategies to deal with confounding factors stated?

7. Were the outcomes measured in a valid and reliable way?

8. Was appropriate statistical analysis used?

Strategy for data synthesis

We will use the Hedges Q statistic and I² statistics to assess between-studies heterogeneity. We will apply a random
effect model to estimate pooled effects in case that the heterogeneity between results will be very high. We will perform
a leave-one-out sensitivity analysis to determine the influence of each study on the overall effect. We will use a funnel
plot and the Egger’s test to assess the publication bias. Statistical analysis will be performed with OpenMeta[Analyst].

Analysis of subgroups or subsets

If the number of data are sufficient, we will perform subgroup analysis according to several variables such as type of
profession, sample size, quality of studies etc.

Contact details for further information

Petros Galanis
pegalan@nurs.uoa.gr

Organisational affiliation of the review

National and Kapodistrian University of Athens

Review team members and their organisational affiliations

Dr Petros Galanis. National and Kapodistrian University of Athens
Dr Irene Vraka. P & A Kyriakou Children's Hospital
Despoina Fragkou. National and Kapodistrian University of Athens
Angeliki Bilali. P & A Kyriakou Children's Hospital
Daphne Kaitelidou. National and Kapodistrian University of Athens

Type and method of review

Meta-analysis, Systematic review

Anticipated or actual start date

06 January 2021

Anticipated completion date

03 February 2021

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International prospective register of systematic reviews

Funding sources/sponsors
None

Conflicts of interest

Language
English

Country
Greece

Stage of review
Review Ongoing

Subject index terms status

Subject indexing assigned by CRD

Subject index terms

COVID-19; Health Personnel; Humans; Pandemics; Personal Protective Equipment; SARS-CoV-2

Date of registration in PROSPERO

12 January 2021

Date of first submission

03 January 2021

Stage of review at time of this submission

The review has not started

Stage Started Completed

Preliminary searches No No

Piloting of the study selection process No No

Formal screening of search results against eligibility criteria No No

Data extraction No No

Risk of bias (quality) assessment No No

Data analysis No No

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International prospective register of systematic reviews

The record owner confirms that the information they have supplied for this submission is accurate and complete and they
understand that deliberate provision of inaccurate information or omission of data may be construed as scientific
misconduct.

The record owner confirms that they will update the status of the review when it is completed and will add publication
details in due course.

Versions
12 January 2021

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